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LUNG CANCER
Erlina MarfiantiIPD FK UII
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Lung Cancer: Defined
Uncontrolled growth of malignant cells in
one or both lungs and tracheo-bronchial
tree
A result of repeated carcinogenic irritation
causing increased rates of cell replication
Proliferation of abnormal cells leads to
hyperplasia, dysplasia or carcinoma in situ
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What is lung cancer?
Lung cancer is the uncontrolled growth of abnormal cells.
These cells develop into tumors and the tumors disruptthe proper function of the lung.
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Picture of the Lungs
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Lung Cancer in the US
According to 2004 statistics,
there were
173,770 new cases and
160,440 deaths yearly More deaths from lung
cancer than prostate, breast
and colorectal cancers
combined
Decreasing incidence and
deaths in men; continued
increase in women
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
1 3 5 10
New Cases
Deaths
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Women & Lung Cancer
80,660new cases were reported in 2004
- Account for 12 % of all new cases
68,510deaths were reported in 2004
- An increase of 150% between 1974 and
1994
Women are more prone to tobacco effects -
1.5 times more likely to develop lung cancer
than men with same smoking habits
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Etiology
Radiation Exposure
Smoking
Environmental/ OccupationalExposure
Asbestos
Radon
Passive smoke
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Smoking Facts
Tobacco use is theleading cause of lungcancer
87% of lung cancersare related to smoking
Risk related to:
age of smoking onset
amount smoked
gender
product smoked
depth of inhalation
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Metastase
Lymph Nodes, Brain, Liver, Adrenal,
Gland, Bones
40% of metastasis occurs in the
Adrenal Gland
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creening No approved screening test proven to improve survival
or detect localized disease
Clinical studies are under way
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Diagnosis
Physical exam
Chest X-ray
CT Scan
PET Scan
MRI
Sputum sample
Bronchoscopy
Biopsy
Chest Xray
PET Scan
CT Scan
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Primary Risk Factors
Tobacco use
&
Secondhand Smoke
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Cough that does not go away
Breathing trouble, such as shortness of breath
Constant chest pain
Coughing up blood A hoarse voice
Frequent lung infections
Feeling tired all the time
Weight loss with no known cause
Symptoms
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Syndromes/Symptoms secondary
to regional metastases:
Esophageal compression dysphagia
Laryngeal nerve paralysis hoarseness
Symptomatic nerve paralysis Horners
syndrome Cervical/thoracic nerve invasion Pancoast
syndrome
Lymphatic obstruction pleural effusion
Vascular obstruction SVC syndrome
Pericardial/cardiac extension effusion,tamponade
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Two Lung Cancer Cells,
ClassifiedNon Small Cell Lung
Cancer (NSCLC)
Adenocarcinoma
Squamous Cell Carcinoma
Large Cell Carcinoma
Small Cell Lung
Cancer (SCLC)
Oat Cell
Intermediate
Combined
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Treatment and Staging
NSCLCStage Description Treatment Options
Stage I a/b Tumor of any size is found only in the
lung
Surgery
Stage II a/b Tumor has spread to lymph nodes
associated with the lung
Surgery
Stage III a Tumor has spread to the lymph nodes
in the tracheal area, including chest
wall and diaphragm
Chemotherapy followed
by radiation or surgery
Stage III b Tumor has spread to the lymph nodeson the opposite lung or in the neck
Combination ofchemotherapy and
radiation
Stage IV Tumor has spread beyond the chest Chemotherapy and/or
palliative (maintenance)
care
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SCLC
Limited StageDefined as tumor involvement of one lung, themediastinum and ipsilateral and/or contralateralsupraclavicular lymph nodes or disease that can
be encompassed in a single radiotherapy port.
Extensive Stage
Defined as tumor that has spread beyond one
lung, mediastinum, and supraclavicular lymphnodes. Common distant sites of metastases arethe adrenals, bone, liver, bone marrow, andbrain.
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Conclusion
Smoking cessation is essential for
prevention of lung cancer.
New screening tools under way.
Clinical trials under way.
New treatments under way.
Treatment can palliate symptoms andimprove quality of life.
Read first bullet again!!